ABSTRACTS
Volume 14, Number 4
June 2009
Vol. 14, Number 4: Contents| Editorial | Abstracts
Efficacy Methods to Evaluate Health Communication and Marketing Campaigns
W. Douglas Evans a; Jennifer Uhrig b; Kevin Davis b; Lauren McCormack b
a The George Washington University, Washington, DC, USA
b RTI International, Research Triangle Park, North Carolina, USA
Communication and marketing are growing areas of health research, but relatively few rigorous efficacy studies have been conducted in these fields. In this article, we review recent health communication and marketing efficacy research, present two case studies that illustrate some of the considerations in making efficacy design choices, and advocate for greater emphasis on rigorous health communication and marketing efficacy research and the development of a research agenda.
Much of the outcomes research in health communication and marketing, especially mass media, utilizes effectiveness designs conducted in real time, in the media markets or communities in which messages are delivered. Such evaluations may be impractical or impossible, however, imiting opportunities to advance the state of health communication and marketing research and the knowledge base on effective campaign strategies, messages, and channels. Efficacy and effectiveness studies use similar measures of behavior change. Efficacy studies, however, offer greater opportunities for experimental control, message exposure, and testing of health communication and marketing theory.
By examining the literature and two in-depth case studies, we identify advantages and limitations to efficacy studies. We also identify considerations for when to adopt efficacy and effectiveness methods, alone or in combination. Finally, we outline a research agenda to investigate issues of internal and external validity, mode of message presentation, differences between marketing and message strategies, and behavioral outcomes.
Knowledge of Human Papillomavirus: Differences by Self-Reported Treatment for Genital Warts and Sociodemographic Characteristics
Jill Koshiol a; Lila Finney Rutten b; Richard P. Moser c; Nicola Hesse d
a Cancer Prevention Fellowship Program, Office of Preventive Oncology and Genetic Epidemiology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA
b Health Communication and Informatics Research Branch, Behavioral Research Program, Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, Maryland, USA
c Behavioral Research Program, Division of Cancer Control and Population Science, National Cancer Institute, Bethesda, Maryland, USA
d Franklin Square Hospital Center, Bethesda, Maryland, USA
The aim of this study was to evaluate knowledge about human papillomavirus (HPV) in individuals with genital warts compared with women from the general population without genital warts. Human papillomavirus (HPV) knowledge among women reporting treatment for genital warts compared with HPV knowledge in women reporting no treatment was assessed using data from the population-based 2005 Health Information National Trends Survey (HINTS). Three percent (N = 97) of women answered “yes” and 97% (N = 3,450) “no” to “Have you ever been treated for venereal warts or condyloma?” Women who reported treatment for genital warts, were more likely to have heard of HPV (odds ratio (OR): 2.4, 95% confidence interval (CI): 1.4-4.2 vs. no or don't know), to have been told they had HPV (OR: 24.5, 95% CI: 11.4-52.8), and to have accurate information about HPV, such as HPV causes cancer (OR: 2.7, 95% CI: 1.8-4.3). A large proportion (41%) of women who reported treatment for genital warts, however, had not heard of HPV. These women tended to be older, poorer, less educated, non-Hispanic Black, less likely to have had a recent Pap test, and divorced, widowed, or separated. Women with genital warts are learning about HPV, but socioeconomically disadvantaged groups may need to be targeted.
Testing a Theory-Based Health Communication Program: A Replication of Go Sun Smart in Outdoor Winter Recreation
Peter A. Andersen a; David B. Buller b; Barbara J. Walkosz c; Julie Maloy b;
Michael D. Scott d; Gary R. Cutter e; Mark B. Dignan f
a San Diego State University, San Diego, California, USA
b Klein Buendel, Inc., Golden, Colorado, USA
c University of Colorado at Denver and Health Sciences Center, Denver, Colorado, USA
d California State University, Chico, California, USA
e University of Alabama, Birmingham, Birmingham, Alabama, USA
f University of Kentucky, Lexington, Kentucky, USA
The epidemic of preventable skin cancer in the United States creates an urgent need for health communication campaigns to improve sun protection. Go Sun Smart (GSS), a theory-driven multichannel health communication campaign showed positive effects on sun safety behaviors of employees and guests in a randomized trial at high-altitude ski areas. In this article we report findings from the North American GSS campaign for guests at ski areas that comprosed the original control-group resorts, replicating the results of the original guest intervention. Results showed that after GSS was deployed, guests at the original control group ski areas increased sun protection and reported greater recall of sun safety messages. Conversely, GSS had no effect on sunburning attitudes or self-efficacy beliefs. Like the original GSS guest intervention, the present study found that greater exposure to GSS messages was associated with greater use of sunscreen, sunscreen lip balm, and face covering, but not gloves or overall sun protection. There was no evidence that GSS decreased sunburning or attitudes and self-efficacy beliefs regarding sun safety.
Pregnancy Intentions and Folic Acid Supplementation Exemplars: Findings from the Central Pennsylvania Women's Health Study
Roxanne Parrott a; Julie E. Volkman b; Marianne M. Hillemeier a; Carol S. Weisman c;
Gary A. Chase c; Anne-Marie Dyer c
a Department of Communication Arts & Sciences, The Pennsylvania State University, University Park, Pennsylvania, USA
b Department of Communication Sciences and Disorders, Emerson College, Boston, Massachusetts, USA
c College of Medicine, The Pennsylvania State University, Hershey Medical Center, Hershey, Pennsylvania, USA
One Healthy People 2010 objective is that 80% of women in the United States start a pregnancy with optimal levels of folic acid. This often requires women to use folic acid supplements preconceptionally to get adequate levels. Efforts to achieve the objective have resulted in a suboptimal floor effect at less than 50% of women. We advance a framework based on exemplification theory, identifying supplementation as an additive action in which two role models exemplify folic acid supplementation among women of reproductive age able to become pregnant (n = 1,258). The women were participants in Phase I of the Central Pennsylvania Women's Health Study (CePAWHS). One exemplar identified represents the positive habits aligned with supplementers considering a pregnancy sometime in their future, while the other resides in the exemplification of positive habits aligned with supplementers not considering a pregnancy sometime in their future but still able to become pregnant. Among women not considering a future pregnancy, daily green salad consumption, weekly fish consumption, having had a health care visit in the past year, and having had any ob/gyn visit in the past 2 years resulted in increased odds of folic acid supplement use in a multivariable model. In the same model, an increase in age resulted in increased odds of folic acid supplement use. Among women considering a future pregnancy, not smoking cigarettes, having higher levels of psychosocial stress, and having higher levels of interaction social support resulted in increased odds of folic acid supplement use in a multivariable model. In the same model, those who have had a health care visit in the past year, as well as those who have received pregnancy planning counseling, were also more likely to use a folic acid supplement. Implications for strategic communication are considered.
Testing Communication Strategies to Convey Genomic Concepts Using Virtual Reality Technology
Kimberly A. Kaphingst a; Susan Persky a; Cade McCall b; Christina Lachance a;
Andrew C. Beall b; Jim Blascovich b
a National Human Genome Research Institute, Bethesda, Maryland, USA
b University of California, Santa Barbara, California, USA
Health professionals need to be able to communicate information about genomic susceptibility in understandable and usable ways, but substantial challenges are involved. We developed four learning modules that varied along two factors: (1) learning mode (active learning vs. didactic learning) and (2) metaphor (risk elevator vs. bridge) and tested them using a 2 2 between-subjects, repeated measures design. The study used an innovative virtual reality technology experimental platform; four virtual worlds were designed to convey the concept that genetic and behavioral factors interact to affect common disease risk. The primary outcome was comprehension (recall, transfer). Study participants were 42 undergraduates aged 19-23. The results indicated that the elevator metaphor better supported learning of the concept than the bridge metaphor. Mean transfer score was significantly higher for the elevator metaphor (p < 0.05). Mean change in recall was significantly higher for didactic learning than active learning (p < 0.05). Mean ratings for variables posited to be associated with better learning (e.g., motivation), however, were generally higher for the active learning worlds. The results suggested that active learning might not always be more effective than didactic learning in increasing comprehension of health information. The findings also indicated that less complex metaphors might convey abstract concepts more effectively.
Using the Extended Parallel Process Model to Explain Physicians' Decisions to Test Their Patients for Kidney Disease
Anthony J. Roberto a; Catherine E. Goodall b
a Arizona State University, Tempe, Arizona, USA
b Kent State University, Kent, Ohio, USA
A study was conducted to determine the effects of perceived threat and efficacy on physicians' intentions and behavior to test their patients' level of kidney functioning. Guided by the extended parallel process model, 151 physicians completed an initial survey measuring threat to patients (i.e., susceptibility and severity) and efficacy (i.e., response-efficacy and self-efficacy), as well as their current intentions and behavior. One-hundred and twelve of these physicians also completed and returned a follow-up survey sent approximately 4 months later using identical measures of intentions and behavior. As predicted, physicians who perceived greater threat to patients and greater efficacy demonstrated greater intentions and behavior to test their patients' level of kidney functioning. The theoretical and practical insights and implications of these findings are discussed.
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